Use of coronary artery stents in the treatment of internal carotid artery stenosis at the base of the skull.

The management of high-grade stenosis involving the petrosal segment of the internal carotid artery has been limited to angioplasty alone in the past. However, if angioplasty fails or has less than optimum results, then endovascular stent placement should be considered. We present the first two known cases in which the Multi-Link coronary stent was used for the treatment of internal carotid disease in the petrosal segment. The first patient had symptomatic stenosis that failed angioplasty after seven months and the second patient had a symptomatic lesion that dissected upon angioplasty. The flexibility and low profile characteristics of the stent allowed it to be safely deployed with balloon expansion. No complications occurred and the patients tolerated the procedure. Patients were carefully monitored and no new neurologic events in six months of follow up occurred. These cases reveal the good clinical results of stent placement for surgically-inaccessible lesions of the internal carotid artery in the skull base.